Table 3.
Incremental cost effectiveness ratios and net benefit statistics for primary outcome (adverse perinatal outcome avoided) for all women at low risk of complications according to planned place of birth: home, freestanding midwifery unit (FMU), or alongside midwifery unit (AMU) with obstetric unit (OU) as reference
| Home | FMU | AMU | |
|---|---|---|---|
| All low risk women | |||
| Cost difference (95% CI) | −565 (−591 to −538) | −196 (−229 to −163) | −170 (−199 to −141) |
| Difference in adverse perinatal outcome* avoided (95% CI) | −0.00007 (−0.0014 to 0.0013) | 0.0004 (−0.0010 to 0.0019) | 0.0005 (−0.0007 to 0.0019) |
| Mean ICER† | 7 950 356 | −431 873 | −296 400 |
| Quadrant on cost effectiveness plane | South west | South east | South east |
| Mean net benefit (95% CI)‡ | 592 (547 to 639) | 263 (211 to 315) | 167 (111 to 224) |
| Mean net benefit (95% CI)§ | 593 (535 to 654) | 270 (205 to 334) | 174 (99 to 244) |
| Nulliparous low risk women | |||
| Cost difference (95% CI) | −281 (−343 to −217) | −163 (−217 to −108) | −92 (−142 to −33) |
| Difference in adverse perinatal outcome* avoided (95% CI) | −0.004 (−0.008 to −0.00001) | 0.0008 (−0.002 to 0.003) | 0.0005 (−0.003 to 0.003) |
| Mean ICER† | 69761 | −98136 | −47995 |
| Quadrant on cost effectiveness plane | South west | South east | South east |
| Mean net benefit (95% CI)‡ | 204 (77 to 319) | 179 (98 to 259) | 103 (9 to 189) |
| Mean net benefit (95% CI)§ | 165 (−2 to 321) | 188 (87 to 289) | 110 (−10 to 217) |
| Multiparous low risk women | |||
| Cost difference (95% CI) | −362 (−390 to −335) | −173 (−208 to −139) | −151 (−184 to −117) |
| Difference in adverse perinatal outcome* avoided (95% CI) | 0.001 (−0.0004 to 0.0025) | 0.0005 (−0.0015 to 0.0024) | 0.0007 (−0.001 to 0.003) |
| Mean ICER† | −323 037 | −128 134 | −119 618 |
| Quadrant on cost effectiveness plane | South east | South east | South east |
| Mean net benefit (95% CI)‡ | 382 (336 to 427) | 182 (120 to 244) | 165 (115 to 222) |
| Mean net benefit (95% CI)§ | 391 (335 to 451) | 186 (107 to 267) | 172 (108 to 244) |
*Composite of perinatal mortality and specified neonatal morbidities: stillbirth after start of care in labour, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, or fractured clavicle.
†95% CI not provided because bootstrapped replicates of incremental cost effectiveness ratios fell across more than one quadrant of cost effectiveness plane.
‡Estimated at £20 000 cost effectiveness threshold.
§Estimated at £30 000 cost effectiveness threshold.